- Hypoglycemia is a condition characterized by abnormally low blood glucose (sugar) levels, typically defined as plasma glucose below 70 mg/dL (3.9 mmol/L), although the threshold may vary depending on individual physiology and clinical context.
- Glucose is the body’s primary energy source, particularly for the brain, which relies almost entirely on a steady supply of glucose to function. When blood sugar drops too low, normal physiological processes are disrupted, leading to a spectrum of symptoms that can range from mild discomfort to severe, life-threatening complications.
- The condition can arise from a variety of causes. In people with diabetes mellitus, hypoglycemia most commonly occurs as a side effect of insulin therapy or oral hypoglycemic medications, especially when dosages are too high relative to food intake, physical activity, or alcohol consumption. In non-diabetic individuals, hypoglycemia may result from prolonged fasting, excessive alcohol intake, hormonal deficiencies (such as adrenal insufficiency), critical illness, insulin-secreting tumors (insulinomas), or postprandial (reactive) fluctuations in glucose regulation.
- The symptoms of hypoglycemia are often divided into neurogenic (autonomic) and neuroglycopenic categories. Neurogenic symptoms, triggered by the release of stress hormones such as epinephrine and glucagon, include sweating, shakiness, palpitations, anxiety, hunger, and irritability. Neuroglycopenic symptoms result from inadequate glucose supply to the brain and can include confusion, blurred vision, difficulty concentrating, dizziness, seizures, and in severe cases, loss of consciousness or coma. Recognizing early signs is essential, as untreated hypoglycemia can quickly progress to dangerous outcomes.
- Management of hypoglycemia focuses on rapid correction of low blood sugar and addressing the underlying cause. For acute episodes, the standard treatment is immediate ingestion of fast-acting carbohydrates, such as glucose tablets, fruit juice, or candy. In severe cases where the individual cannot ingest food, glucagon injections or intravenous glucose are administered. For people with diabetes, prevention strategies include careful monitoring of blood glucose, adjusting medication dosages, coordinating meals with insulin or oral drugs, and educating patients to recognize and respond quickly to early warning signs.
- Chronic or recurrent hypoglycemia requires thorough evaluation to identify underlying causes and tailor long-term management. This may include adjusting diabetes treatment regimens, treating hormonal deficiencies, removing insulin-secreting tumors, or implementing dietary strategies such as frequent small meals to stabilize glucose levels. Advances in technology, such as continuous glucose monitoring (CGM) systems and insulin pumps with automated shutoff functions, have significantly reduced the risk of severe hypoglycemia in diabetic patients by providing real-time alerts and precise insulin delivery.
